Keywords: hypocalcemia
Cases of electrolyte disorders, of course, are often mentioned with hypocalcemia, and calcium gluconate is the preferred drug for rescuing hypocalcemia crises, and there is no one.
The stability of blood calcium is always maintained under the game of numerous hormones such as PTH, calcitonin, and vitamin D. When hypocalcemia occurs, its clinical manifestations are always related to increased excitability of the neuromuscular system. It is worth mentioning that the severity of clinical symptoms may not necessarily be related to the degree of hypocalcemia, but rather to the speed and duration of blood calcium decline. Due to the fact that calcium ions can reduce neuromuscular excitability, neuromuscular excitability increases during hypocalcemia, leading to muscle spasms and early numbness in the peripheral nervous system
Mild patients can induce typical tics using facial nerve tapping test or brachial compression test. Severe cases can lead to spasms in the throat, wrists, feet, bronchi, etc., seizures, and even apnea, as well as mental symptoms such as restlessness, depression, and cognitive impairment.
When blood calcium is below 0.88 mmol/l, this is the legendary low calcium crisis. Severe skeletal muscle or smooth muscle spasms can occur, leading to seizures or seizures. So in clinical practice, some patients may be misdiagnosed as "symptomatic epilepsy", after all, there are too many pits, so we must clean our eyes.
The consequences caused by low calcium are not the most severe, only the more severe. This is the laryngeal muscle spasm that causes suffocation, sudden cardiac arrest, and thus endangers life.
So, when hypocalcemia occurs, it is important to identify and intervene early.
Preferably 10% calcium gluconate 10-20 ml+glucose or physiological saline 20-40 ml, diluted and slowly injected intravenously (injection time of more than 10 minutes); Subsequently, 1-3 mg/kg/h continuous intravenous infusion of calcium gluconate (10 g of calcium gluconate added to 1000 ml of 5% glucose solution) was performed. During the course of the disease, it is necessary to closely monitor the changes in blood calcium, reduce the dosage after 24 to 48 hours, and then switch to oral calcium and active vitamin D treatment.